Part B Insider (Multispecialty) Coding Alert

Medicare administrative cutbacks have been a boon to Part B providers over the last year. A new patient-first initiative promises to change Medicare clinicians' burdens - but not necessarily reduce them.

Context: Last October, President Trump urged his administration to put patients first and reorganize federal healthcare programs with the "Executive Order to Promote Healthcare Choice and Competition Across the United States." Rollbacks to administrative burdens have dotted the Medicare landscape since the Order was released - from the Quality Payment Program (QPP) Year 2 changes to "Patients Over Paperwork."

According to a recent announcement from CMS, the deregulation train is just getting started. The feds want patients, not physicians, to control healthcare data and make it available for patients to carry with them wherever they go.

"The government-wide MyHealthEData initiative" hopes to "empower patients," and "help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice," said a CMS press release on the new program. The initiative puts cost, quality, and competition on the front burner, giving patients control of their histories and health information. The program allows patients to determine where they want to take their records, and who they want to give their business to, the agency suggests in the release.

Nuts and bolts: CMS introduced a new "universal digital format" for Medicare patients to access their data called "Blue Button 2.0" at the Healthcare Information and Management Systems Society (HIMSS) Annual Conference in Las Vegas. The program will promote application designs and technology from more than 100 health IT organizations.

Remember: The Blue Button program is not new, but is actually a revamp of a program that began in 2010, which gave patients their health data in a downloadable PDF file, CMS reminded. Blue Button 2.0, however, will allow patients to utilize the program "on applications designed to help them manage their health, or share it with their doctors to improve clinical decision-making," a fact sheet said. The upgrade will include up to four years of beneficiaries' Medicare Parts A, B, and D details, including prescriptions and treatments.

"CMS serves more than 130 million beneficiaries through our programs, which means we are uniquely positioned to transform how important healthcare data is shared between patients and their doctors," said Seema Verma, CMS Administrator in her HIMSS speech. She also encouraged private payers to embrace these initiatives, ensuring their patients have easy access to health information, too.

AMA Offers Assistance and Praise on HIT Revamps

Physician and hospital groups have pushed repeatedly for change as the paperwork required to care effectively for patients has increased exponentially in recent years, bogging down providers and taking time away from the actual care of patients.

The American Medical Association (AMA) agrees with Medicare's updates. "We look forward to working with the administration in fleshing out the details to ensure that physicians get to spend more time caring for their patients and less time on administrative tasks," said David O. Barbe, MD, AMA president in a recent release. "There is room for improvement, and we are excited that Administrator Verma agrees."